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Kazemi A, Soltani S, Aune D, Hosseini E, Mokhtari Z, Hassanzadeh Z, Jayedi A, Pitanga F, Akhlaghi M. Leisure-time and occupational physical activity and risk of cardiovascular disease incidence: a systematic-review and dose-response meta-analysis of prospective cohort studies. Int J Behav Nutr Phys Act 2024; 21:45. [PMID: 38659024 PMCID: PMC11044601 DOI: 10.1186/s12966-024-01593-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 04/14/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Physical activity has benefits for the cardiovascular system, however, what levels and types of activity provide optimal cardiovascular health is unclear. We aimed to determine the level of physical activity that has the most benefits against cardiovascular diseases (CVD). METHODS PubMed, Scopus, and Web of Science were searched for prospective cohort studies on leisure-time (LTPA) or occupational physical activity (OPA) as the exposure and major types of CVD (total CVD, coronary heart disease [CHD], stroke, and atrial fibrillation [AF]) incidence as the outcome. Risk of bias of studies was evaluated using the ROBINS-I tool. Summary hazard ratios (HR) were calculated using random-effects pairwise model. RESULTS A total of 103 studies were included in the analysis. The highest versus the lowest LTPA was associated with a lower risk of overall CVD (HR = 0.81; 95% CI: 0.77-0.86), CHD (HR = 0.83; 0.79-0.88), and stroke (HR = 0.83; 0.79-0.88), but not AF (HR = 0.98; 0.92-1.05). Linear dose-response analyses showed a 10%, 12%, 9%, and 8% risk reduction in CVD, CHD, stroke, and AF incidence, respectively, for every 20 MET-hours/week increase in LTPA. In nonlinear dose-response analyses, there were inverse associations up to 20 MET-hours/week with 19% and 20% reduction in CVD and CHD risk, and up to 25 MET-hours/week with 22% reduction in stroke, with no further risk reduction at higher LTPA levels. For AF, there was a U-shaped nonlinear association with the maximum 8% risk reduction at 10 MET-hours/week of LTPA. Higher levels of OPA were not associated with risk of CVD, CHD, stroke, or AF. CONCLUSIONS Overall, results showed an inverse dose-response relationship between LTPA and risk of CVD, CHD, stroke, and AF. Running was the most beneficial LTPA but the risk was similar among various LTPA intensities. OPA showed no benefits in total or any type of CVD.
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Affiliation(s)
- Asma Kazemi
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sepideh Soltani
- Cardiovascular Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Dagfinn Aune
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
- Department of Nutrition, Oslo New University College, Oslo, Norway
- Department of Endocrinology, Morbid Obesity and Preventive Medicine, Oslo University Hospital, Oslo, Norway
| | - Elham Hosseini
- Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zeinab Mokhtari
- Nutrition and Food Security Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zahra Hassanzadeh
- Nutrition Research Center, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Jayedi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | | | - Masoumeh Akhlaghi
- Department of Community Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Razi Blvd, 7153675541, Shiraz, Iran.
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2
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Sanchez Rico M, Plessz M, Airagnes G, Wiernik E, Hoertel N, Goldberg M, Zins M, Meneton P. Lifetime exposure to unemployment and prior working conditions are associated with retiree's health: A retrospective study in a large population-based French cohort. Soc Sci Med 2024; 341:116550. [PMID: 38160610 DOI: 10.1016/j.socscimed.2023.116550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 12/05/2023] [Accepted: 12/21/2023] [Indexed: 01/03/2024]
Abstract
It is unclear whether unemployment exposure, as well as working conditions, can have sustained effects on the health of retirees who are no longer exposed. The aim of the present study is to investigate this issue in 29,281 French retirees from the CONSTANCES cohort in whom the prevalence of suboptimal self-rated health, disability for routine tasks, cardiovascular diseases and cancers is assessed according to lifetime exposure to unemployment and prior working conditions. The analyses are performed retrospectively using multivariable logistic regression models with adjustment for potential confounders such as sex, birth year, parental histories of cardiovascular disease and cancer, social position, retirement age and duration. High lifetime exposure to unemployment is associated with an increased prevalence of suboptimal self-rated health (adjusted odds ratio (95% CI), 1.39 (1.23-1.57)), disability for routine tasks (1.41 (1.26-1.57)) and several cardiovascular diseases including stroke (1.66 (1.19-2.31)), myocardial infarction (1.65 (1.18-2.31)) and peripheral arterial disease (2.38 (1.46-3.90)). Bad prior working conditions are associated with an increased prevalence of disability for routine tasks (1.17 (1.04-1.33)) and cancers (1.27 (1.04-1.54)), notably prostate cancer (1.60 (1.01-2.64)). These findings suggest that unemployment and working conditions have long-term health effects that may cumulate over lifetime, emphasizing that risk evaluation and preventive strategies in retirees, as in workers, should take into account the life-course of individuals in addition to traditional risk factors.
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Affiliation(s)
- Marina Sanchez Rico
- AP-HP, DMU Psychiatrie et Addictologie, Hôpital Corentin-Celton, Issy-les-Moulineaux, France
| | - Marie Plessz
- Centre Maurice Halbwachs, INRAE, EHESS, ENS-PSL, CNRS, Paris, France
| | - Guillaume Airagnes
- AP-HP, DMU Psychiatrie et Addictologie, Hôpital européen Georges-Pompidou, Paris, France; Université Paris Cité, Faculté de Médecine, Paris, France
| | - Emmanuel Wiernik
- Université Paris Cité, Université Paris-Saclay, UVSQ, UMS_011 INSERM, Villejuif, France
| | - Nicolas Hoertel
- AP-HP, DMU Psychiatrie et Addictologie, Hôpital Corentin-Celton, Issy-les-Moulineaux, France; Université Paris Cité, Faculté de Médecine, Paris, France; UMR_1266, INSERM, Paris, France
| | - Marcel Goldberg
- Université Paris Cité, Université Paris-Saclay, UVSQ, UMS_011 INSERM, Villejuif, France
| | - Marie Zins
- Université Paris Cité, Faculté de Médecine, Paris, France; Université Paris Cité, Université Paris-Saclay, UVSQ, UMS_011 INSERM, Villejuif, France
| | - Pierre Meneton
- UMR_1142 INSERM, Sorbonne Université, Université Paris 13, Paris, France.
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Gouze H, Aegerter P, Said-Nahal R, Zins M, Goldberg M, Morelle G, Schett G, Breban M, D'Agostino MA. Rheumatoid arthritis, as a clinical disease, but not rheumatoid arthritis-associated autoimmunity, is linked to cardiovascular events. Arthritis Res Ther 2022; 24:56. [PMID: 35209936 PMCID: PMC8867622 DOI: 10.1186/s13075-022-02722-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Accepted: 01/13/2022] [Indexed: 11/10/2022] Open
Abstract
Background Rheumatoid arthritis (RA) is characterized by increased cardiovascular (CV) mortality. CV events are particularly high in patients with RA-specific autoimmunity, including rheumatoid factor (RF) and anti-citrullinated protein antibodies (ACPA), raising the question whether RA-specific autoimmunity itself is associated with CV events. Methods New CV events (myocardial infarction, stroke or death by CV cause) were recorded in 20,625 subjects of the Electricité de France – Gaz de France (GAZEL) cohort. Self-reported RA cases in the GAZEL cohort were validated by phone interview on the basis of a specific questionnaire. In 1618 subjects, in whom plasma was available, RF and ACPA were measured. A piecewise exponential Poisson regression was used to analyze the association of CV events with presence of RA as well as RA-specific autoimmunity (without RA). Results CV events in GAZEL were associated with age, male sex, smoking, hypertension, hyperlipidemia, and diabetes mellitus (HR from 1.06 to 1.87, p < 0.05). Forty-two confirmed RA cases were identified. Confirmed RA was significantly associated with CV risk increase (HR of 3.03; 95% CI: 1.13–8.11, p = 0.03) independently of conventional CV risk factors. One hundred seventy-eight subjects showed RF or ACPA positivity without presence of RA. CV events were not associated with ACPA positivity (HR: 1.52, 95% CI: 0.47–4.84, p = 0.48) or RF positivity (HR: 1.15, 95% CI: 0.55–2.40, p = 0.70) in the absence of RA. Conclusions RA, as a clinical chronic inflammatory disease, but not mere positivity for RF or ACPA in the absence of clinical disease is associated with increased CV risk. Supplementary Information The online version contains supplementary material available at 10.1186/s13075-022-02722-z.
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Affiliation(s)
- Hélène Gouze
- Infection & Inflammation, UMR 1173, Inserm, UVSQ/Paris Saclay, 78180, Montigny-le-Bretonneux, France. .,Service de Rhumatologie, Hôpital Ambroise Paré, AP-HP-Paris Saclay, 92100, Boulogne, France. .,Laboratoire d'Excellence Inflamex, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.
| | - Philippe Aegerter
- Inserm U1018 - Center for Research in Epidemiology and Population Health (CESP), Integrative Respiratory Epidemiology Team, Paris Saclay University, Villejuif, France
| | - Roula Said-Nahal
- Infection & Inflammation, UMR 1173, Inserm, UVSQ/Paris Saclay, 78180, Montigny-le-Bretonneux, France.,Service de Rhumatologie, Hôpital Ambroise Paré, AP-HP-Paris Saclay, 92100, Boulogne, France.,Laboratoire d'Excellence Inflamex, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Marie Zins
- Population-based Cohorts Unit-UMS 011, Paris University, Villejuif, France
| | - Marcel Goldberg
- Population-based Cohorts Unit-UMS 011, Paris University, Villejuif, France
| | - Guillaume Morelle
- Service de Rhumatologie, Hôpital Ambroise Paré, AP-HP-Paris Saclay, 92100, Boulogne, France
| | - Georg Schett
- Department of Internal Medicine 3 - Rheumatology and Immunology, Friedrich-Alexander University (FAU), Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany.,Deutsches Zentrum für Immuntherapie, Friedrich-Alexander University (FAU), Erlangen-Nuremberg and Universitätsklinikum Erlangen, Erlangen, Germany
| | - Maxime Breban
- Infection & Inflammation, UMR 1173, Inserm, UVSQ/Paris Saclay, 78180, Montigny-le-Bretonneux, France.,Service de Rhumatologie, Hôpital Ambroise Paré, AP-HP-Paris Saclay, 92100, Boulogne, France.,Laboratoire d'Excellence Inflamex, Université Paris Descartes, Sorbonne Paris Cité, Paris, France
| | - Maria Antonietta D'Agostino
- Infection & Inflammation, UMR 1173, Inserm, UVSQ/Paris Saclay, 78180, Montigny-le-Bretonneux, France.,Service de Rhumatologie, Hôpital Ambroise Paré, AP-HP-Paris Saclay, 92100, Boulogne, France.,Laboratoire d'Excellence Inflamex, Université Paris Descartes, Sorbonne Paris Cité, Paris, France.,Istituto di Reumatologia, Università Cattolica del Sacro Cuore, Fondazione Policlinico Universitario Agostino Gemelli IRCSS, Rome, Italy
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4
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Hoertel N, Sanchez Rico M, Limosin F, Ménard J, Ribet C, Bonenfant S, Goldberg M, Zins M, Meneton P. Respective Mediating Effects of Social Position and Work Environment on the Incidence of Common Cardiovascular Risk Factors. J Am Heart Assoc 2022; 11:e021373. [PMID: 35023345 PMCID: PMC9238532 DOI: 10.1161/jaha.121.021373] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background Social position and work environment are highly interrelated and their respective contribution to cardiovascular risk is still debated. Methods and Results In a cohort of 20 625 French workers followed for 25 years, discrete‐time survival analysis with reciprocal mediating effects, adjusted for sex, age, and parental history of early coronary heart disease, was performed using Bayesian structural equation modeling to simultaneously investigate the extent to which social position mediates the effect of work environment and, inversely, the extent to which work environment mediates the effect of social position on the incidence of common cardiovascular risk factors. Depending on the factor, social position mediates 2% to 53% of the effect of work environment and work environment mediates 9% to 87% of the effect of social position. The mediation by work environment is larger than that by social position for the incidence of obesity, hypertension, dyslipidemia, diabetes, sleep complaints, and depression (mediation ratios 1.32–41.5, 6.67 when modeling the 6 factors together). In contrast, the mediation by social position is larger than that by work environment for the incidence of nonmoderate alcohol consumption, smoking, and leisure‐time physical inactivity (mediation ratios 0.16–0.69, 0.26 when modeling the 3 factors together). Conclusions The incidence of behavioral risk factors seems strongly dependent on social position whereas that of clinical risk factors seems closely related to work environment, suggesting that preventive strategies should be based on education and general practice for the former and on work organization and occupational medicine for the latter.
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Affiliation(s)
- Nicolas Hoertel
- Département de Psychiatrie Institut de Psychiatrie et Neurosciences de Paris Faculté de Médecine Hôpital Corentin-Celton INSERM UMR_S1266 AP-HPUniversité de Paris Issy-les-Moulineaux France
| | - Marina Sanchez Rico
- Département de Psychiatrie Institut de Psychiatrie et Neurosciences de Paris Faculté de Médecine Hôpital Corentin-Celton INSERM UMR_S1266 AP-HPUniversité de Paris Issy-les-Moulineaux France
| | - Frédéric Limosin
- Département de Psychiatrie Institut de Psychiatrie et Neurosciences de Paris Faculté de Médecine Hôpital Corentin-Celton INSERM UMR_S1266 AP-HPUniversité de Paris Issy-les-Moulineaux France
| | - Joël Ménard
- UMR_1142 INSERM Sorbonne UniversitéUniversité Paris 13 Paris France
| | - Céline Ribet
- UMS_011 INSERM Université Paris-Saclay Villejuif France
| | | | | | - Marie Zins
- UMS_011 INSERM Université Paris-Saclay Villejuif France
| | - Pierre Meneton
- UMR_1142 INSERM Sorbonne UniversitéUniversité Paris 13 Paris France
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5
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Mwene-Batu P, Bisimwa G, Ngaboyeka G, Dramaix M, Macq J, Hermans MP, Lemogoum D, Donnen P. Severe acute malnutrition in childhood, chronic diseases, and human capital in adulthood in the Democratic Republic of Congo: the Lwiro Cohort Study. Am J Clin Nutr 2021; 114:70-79. [PMID: 33826712 PMCID: PMC8246611 DOI: 10.1093/ajcn/nqab034] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 01/29/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Little is known about the long-term outcome of children treated for severe acute malnutrition (SAM) after nutritional rehabilitation. OBJECTIVES To explore the association between SAM in childhood, noncommunicable diseases (NCDs), and low human capital in adulthood. METHODS We identified 524 adults (median age: 22 y) who were treated for SAM during childhood in Eastern Democratic Republic of Congo between 1988 and 2007. They were compared with 407 community unexposed age- and sex-matched subjects with no history of SAM. The variables of interest were cardiometabolic risk markers for NCDs and human capital. For the comparison, we used linear and logistic regressions to estimate the association between SAM in childhood and the risk of NCDs and ordinal logistic regression for the human capital. RESULTS Compared with unexposed subjects, the exposed participants had a higher waist circumference [1.2 (0.02, 2.3) cm; P = 0.015], and a larger waist-to-height ratio [0.01 (0.01, 0.02) cm; P < 0.001]. On the other hand, they had a smaller hip circumference [-1.5 (-2.6, -0.5) cm; P = 0.021]. Regarding cardiometabolic markers for NCDs, apart from a higher glycated hemoglobin (HbA1c) [0.4 (0.2, 0.6); P < 0.001], no difference was observed in other cardiometabolic markers for NCD between the 2 groups. Compared with unexposed participants, exposed participants had a higher risk of metabolic syndrome (crude OR: 2.35; 95% CI: 1.22, 4.54; P = 0.010) and visceral obesity [adjusted OR: 1.44 (1.09, 1.89); P = 0.001]. The prevalence of hypertension, diabetes, overweight, and dyslipidaemia was similar in both groups. Last, the proportion of malnutrition survivors with higher socioeconomic status level was lower. CONCLUSION SAM during childhood was associated with a high risk of NCDs and lower human capital in adulthood. Thus, policymakers and funders seeking to fight the global spread of NCDs in adults in low-resource settings should consider the long-term benefit of reducing childhood SAM as a preventive measure to reduce the socioeconomic burden attributable to NCDs.
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Affiliation(s)
- Pacifique Mwene-Batu
- Ecole Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
- Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
- Nutritional department, Centre de Recherche en Sciences Naturelles, Lwiro, Democratic Republic of Congo
- Hôpital Provincial General de Reference de Bukavu, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
| | - Ghislain Bisimwa
- Ecole Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
- Nutritional department, Centre de Recherche en Sciences Naturelles, Lwiro, Democratic Republic of Congo
| | - Gaylord Ngaboyeka
- Ecole Régionale de Santé Publique, Université Catholique de Bukavu, Bukavu, Democratic Republic of Congo
- Nutritional department, Centre de Recherche en Sciences Naturelles, Lwiro, Democratic Republic of Congo
| | - Michèle Dramaix
- Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
| | - Jean Macq
- Institute of Health and Society, Université Catholique de Louvain, Brussels, Belgium
| | - Michel P Hermans
- Division of Endocrinology & Nutrition, Cliniques universitaires St-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Daniel Lemogoum
- Hôpital ULB-Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Philippe Donnen
- Ecole de Santé Publique, Université Libre de Bruxelles, Brussels, Belgium
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6
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Hamieh N, Kab S, Zins M, Blacher J, Meneton P, Empana JP, Hoertel N, Limosin F, Goldberg M, Melchior M, Lemogne C. Depressive symptoms and non-adherence to treatable cardiovascular risk factors' medications in the CONSTANCES cohort. EUROPEAN HEART JOURNAL. CARDIOVASCULAR PHARMACOTHERAPY 2020; 7:280-286. [PMID: 33200205 DOI: 10.1093/ehjcvp/pvaa124] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2020] [Revised: 09/28/2020] [Accepted: 10/14/2020] [Indexed: 12/21/2022]
Abstract
AIMS Depression is associated with increased risk of cardiovascular disease (CVD) and the role of poor medical adherence is mostly unknown. We studied the association between depressive symptoms and non-adherence to medications targeting treatable cardiovascular risk factors in the CONSTANCES population-based French cohort. METHODS AND RESULTS We used CONSTANCES data linked to the French national healthcare database to study the prospective association between depressive symptoms (assessed at inclusion with the Center for Epidemiological Studies Depression scale) and non-adherence to medications (less than 80% of trimesters with at least one drug dispensed) treating type 2 diabetes, hypertension, and dyslipidaemia over 36 months of follow-up. Binary logistic regression models were adjusted for socio-demographics, body mass index, and personal history of CVD at inclusion. Among 4998 individuals with hypertension, 793 with diabetes, and 3692 with dyslipidaemia at baseline, respectively 13.1% vs. 11.5%, 10.5% vs. 5.8%, and 29.0% vs. 27.1% of those depressed vs. those non-depressed were non-adherent over the first 18 months of follow-up (15.9% vs. 13.6%, 11.1% vs. 7.4%, and 34.8% vs. 36.6% between 19 and 36 months). Adjusting for all covariates, depressive symptoms were neither associated with non-adherence to medications for hypertension, diabetes, and dyslipidaemia over the first 18 months of follow-up, nor afterwards. Depressive symptoms were only associated with non-adherence to anti-diabetic medications between the first 3-6 months of follow-up. CONCLUSION Non-adherence to medications targeting treatable cardiovascular risk factors is unlikely to explain much of the association between depressive symptoms and CVD at a population level. Clinicians are urged to search for and treat depression in individuals with diabetes to foster medications adherence.
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Affiliation(s)
- Nadine Hamieh
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Équipe de Recherche en Épidémiologie Sociale, Paris F75012, France
| | - Sofiane Kab
- INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | - Marie Zins
- INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France.,Université de Paris, Faculty of Health, School of Medicine, Paris, France
| | - Jacques Blacher
- Université de Paris, Faculty of Health, School of Medicine, Paris, France.,AP-HP, Centre-Université de Paris, Hôtel-Dieu Hospital, Hypertension and Cardiovascular Prevention Unit, Paris, France
| | - Pierre Meneton
- INSERM U1142 LIMICS, UMRS 1142, Sorbonne Universities, UPMC University of Paris 06, University of Paris 13, Paris, France
| | - Jean-Philippe Empana
- Université de Paris, INSERM U970, Paris Cardiovascular Research Centre (PARCC), Team 4 Integrative Epidemiology of Cardiovascular Diseases, Paris, France
| | - Nicolas Hoertel
- Université de Paris, Faculty of Health, School of Medicine, Paris, France.,Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France.,AP-HP, Centre-Université de Paris, Hôpital Corentin-Celton, Service de psychiatrie et d'addictologie de l'adulte et du sujet âgé, Issy-les-Moulineaux, France
| | - Frederic Limosin
- Université de Paris, Faculty of Health, School of Medicine, Paris, France.,Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France.,AP-HP, Centre-Université de Paris, Hôpital Corentin-Celton, Service de psychiatrie et d'addictologie de l'adulte et du sujet âgé, Issy-les-Moulineaux, France
| | - Marcel Goldberg
- INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France.,Université de Paris, Faculty of Health, School of Medicine, Paris, France
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Équipe de Recherche en Épidémiologie Sociale, Paris F75012, France
| | - Cedric Lemogne
- Université de Paris, Faculty of Health, School of Medicine, Paris, France.,Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris, France.,AP-HP, Centre-Université de Paris, Hôpital Hôtel-Dieu, Service de psychiatrie de l'adulte, Paris, France
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7
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Agher D, Sedki K, Tsopra R, Despres S, Jaulent MC. Influence of Connected Health Interventions for Adherence to Cardiovascular Disease Prevention: A Scoping Review. Appl Clin Inform 2020; 11:544-555. [PMID: 32814353 PMCID: PMC7438176 DOI: 10.1055/s-0040-1715649] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 07/10/2020] [Indexed: 10/23/2022] Open
Abstract
BACKGROUND Recent health care developments include connected health interventions to improve chronic disease management and/or promote actions reducing aggravating risk factors for conditions such as cardiovascular diseases. Adherence is one of the main challenges for ensuring the correct use of connected health interventions over time. OBJECTIVE This scoping review deals with the connected health interventions used in interventional studies, describing the ways in which these interventions and their functions effectively help patients to deal with cardiovascular risk factors over time, in their own environments. The objective is to acquire knowledge and highlight current trends in this field, which is currently both productive and immature. METHODS A structured literature review was constructed from Medline-indexed journals in PubMed. We established inclusion criteria relating to three dimensions (cardiovascular risk factors, connected health interventions, and level of adherence). Our initial search yielded 98 articles; 78 were retained after screening on the basis of title and abstract, 49 articles underwent full-text screening, and 24 were finally retained for the analysis, according to preestablished inclusion criteria. We excluded studies of invasive interventions and studies not dealing with digital health. We extracted a description of the connected health interventions from data for the population or end users. RESULTS We performed a synthetic analysis of outcomes, based on the distribution of bibliometrics, and identified several connected health interventions and main characteristics affecting adherence. Our analysis focused on three types of user action: to read, to do, and to connect. Finally, we extracted current trends in characteristics: connect, adherence, and influence. CONCLUSION Connected health interventions for prevention are unlikely to affect outcomes significantly unless other characteristics and user preferences are considered. Future studies should aim to determine which connected health design combinations are the most effective for supporting long-term changes in behavior and for preventing cardiovascular disease risks.
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Affiliation(s)
- Dahbia Agher
- INSERM, University Sorbonne Paris Nord, Sorbonne University, Laboratory of Medical Informatics and Knowledge Engineering in e-Health, LIMICS, Paris, France
- BeWellConnect, Research and Development, Visiomed Group 75016 Paris, France
| | - Karima Sedki
- INSERM, University Sorbonne Paris Nord, Sorbonne University, Laboratory of Medical Informatics and Knowledge Engineering in e-Health, LIMICS, Paris, France
| | - Rosy Tsopra
- INSERM, Université Paris Descartes, Sorbonne Université, Centre de Recherche des Cordeliers, Information Sciences to support Personalized Medicine, F-75006 Paris, France
- Department of Medical Informatics, H⊚pital Européen Georges-Pompidou, AP-HP, Paris, France
| | - Sylvie Despres
- INSERM, University Sorbonne Paris Nord, Sorbonne University, Laboratory of Medical Informatics and Knowledge Engineering in e-Health, LIMICS, Paris, France
| | - Marie-Christine Jaulent
- INSERM, University Sorbonne Paris Nord, Sorbonne University, Laboratory of Medical Informatics and Knowledge Engineering in e-Health, LIMICS, Paris, France
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8
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Hamieh N, Meneton P, Zins M, Goldberg M, Wiernik E, Empana JP, Limosin F, Melchior M, Lemogne C. Hostility, depression and incident cardiac events in the GAZEL cohort. J Affect Disord 2020; 266:381-386. [PMID: 32056903 DOI: 10.1016/j.jad.2020.01.164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Revised: 11/25/2019] [Accepted: 01/28/2020] [Indexed: 11/15/2022]
Abstract
BACKGROUND Psychological factors such as hostility and depression have been associated with cardiovascular disease. However, their role in predicting incident cardiac events independently one of another is not clear. METHODS Among 10,304 GAZEL middle-aged workers free of cardiovascular diseases in 1993, 581 incident cardiac events were validated from 1994-2014. Hostile traits (cognitive hostility, behavioral hostility, irritability and negativism) were assessed with the Buss and Durkee Hostility Inventory at baseline. Depressive symptoms were assessed at baseline and every three years with the Center for Epidemiological Studies Depression scale. We used Cox proportional hazards models to calculate hazard ratios (HR) of hostile traits for incident cardiac events adjusting for baseline self-reported socio-demographics and family history of coronary heart diseases (model 1), then additionally for time-dependent depressive symptoms (either as a binary or continuous variable) (model 2) and for yearly self-reported modifiable cardiovascular risk factors (physical activity, smoking, body mass index, diabetes, dyslipidemia and hypertension) (model 3). RESULTS In Model 1, the only hostile trait associated with incident cardiac events was irritability (HR for one interquartile range: 1.16, 95% confidence interval: 1.02-1.32). This association was no longer statistically significant when further adjusting for depressive symptoms. Depressive symptoms, in turn, remained significant predictors of cardiac events with HRs ranging from 1.40-1.49 (binary). LIMITATIONS Hostility traits were measured only once. CONCLUSIONS Depressive symptoms might explain the association between irritability and cardiac events and should therefore be prioritized in interventions aiming to prevent cardiovascular disease. Further research is needed to identify the mechanisms underlying this association.
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Affiliation(s)
- Nadine Hamieh
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Équipe de Recherche en Épidémiologie Sociale, F75012, Paris, France.
| | - Pierre Meneton
- INSERM U1142 LIMICS, UMRS 1142, Sorbonne Universities, UPMC University of Paris 06, University of Paris 13, Paris, France
| | - Marie Zins
- Université de Paris, Faculty of Medicine, Paris, France; INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | - Marcel Goldberg
- Université de Paris, Faculty of Medicine, Paris, France; INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | - Emmanuel Wiernik
- INSERM, Population-based Epidemiological Cohorts Unit, UMS 011, Villejuif, France
| | | | - Frederic Limosin
- Université de Paris, Faculty of Medicine, Paris, France; AP-HP.Centre-Université de Paris, Hôpital européen Georges-Pompidou, Service de psychiatrie et d'addictologie de l'adulte et du sujet âgé, Paris, France; Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris
| | - Maria Melchior
- Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, IPLESP, Équipe de Recherche en Épidémiologie Sociale, F75012, Paris, France
| | - Cedric Lemogne
- Université de Paris, Faculty of Medicine, Paris, France; AP-HP.Centre-Université de Paris, Hôpital européen Georges-Pompidou, Service de psychiatrie et d'addictologie de l'adulte et du sujet âgé, Paris, France; Université de Paris, INSERM, Institut de Psychiatrie et Neurosciences de Paris (IPNP), UMR_S1266, Paris
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Hamieh N, Meneton P, Wiernik E, Limosin F, Zins M, Goldberg M, Melchior M, Lemogne C. Depression, treatable cardiovascular risk factors and incident cardiac events in the Gazel cohort. Int J Cardiol 2019; 284:90-95. [DOI: 10.1016/j.ijcard.2018.10.013] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 09/12/2018] [Accepted: 10/03/2018] [Indexed: 11/24/2022]
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10
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Leisure but not household physical activities associates with metabolic syndrome in middle-aged and older individuals: a cross-sectional study. Int J Diabetes Dev Ctries 2019. [DOI: 10.1007/s13410-018-0639-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Work environment mediates a large part of social inequalities in the incidence of several common cardiovascular risk factors: Findings from the Gazel cohort. Soc Sci Med 2018; 216:59-66. [DOI: 10.1016/j.socscimed.2018.09.042] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 09/20/2018] [Accepted: 09/22/2018] [Indexed: 01/10/2023]
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12
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Denolle T, Ménard J. Le nécessaire tournant organisationnel de la France dans les maladies hypertensives. Presse Med 2018; 47:839-841. [DOI: 10.1016/j.lpm.2018.10.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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13
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Cardiovascular risk goes up as your mood goes down: Interaction of depression and socioeconomic status in determination of cardiovascular risk in the CONSTANCES cohort. Int J Cardiol 2018; 262:99-105. [DOI: 10.1016/j.ijcard.2018.02.033] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/08/2017] [Revised: 02/08/2018] [Accepted: 02/08/2018] [Indexed: 01/05/2023]
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14
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Kruisbrink M, Robertson W, Ji C, Miller MA, Geleijnse JM, Cappuccio FP. Association of sleep duration and quality with blood lipids: a systematic review and meta-analysis of prospective studies. BMJ Open 2017; 7:e018585. [PMID: 29247105 PMCID: PMC5735405 DOI: 10.1136/bmjopen-2017-018585] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Revised: 11/09/2017] [Accepted: 11/09/2017] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVES To assess the longitudinal evidence of the relationships between sleep disturbances (of quantity and quality) and dyslipidaemia in the general population and to quantify such relationships. SETTING Systematic review and meta-analysis following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. METHODS We performed a systematic search of PubMed and Embase (up to 9 September 2017), complemented with manual searches, of prospective population studies describing the association between sleep duration and quality and the incidence of dyslipidaemias. Relative risks (95% CIs) were extracted and pooled using a random effects model. Subgroup analyses by lipid type were performed. Heterogeneity and publication bias were also assessed. Quality was assessed with Downs and Black score. PARTICIPANTS Studies were included if they were prospective, had measured sleep quantity and/or quality at baseline and either incident cases of dyslipidaemia or changes in blood lipid fractions assessed prospectively. PRIMARY OUTCOME MEASURES Incidence of dyslipidaemia and changes in lipid fractions. Dyslipidaemia was defined as a high total cholesterol, triglycerides, low-density lipoprotein cholesterol or low high-density lipoprotein cholesterol compared with the reference group. RESULTS Thirteen studies were identified (eight using sleep duration, four sleep quality and one both). There was heterogeneity in the sleep quality aspects and types of lipids assessed. Classification of sleep duration (per hour/groups) also varied widely. In the pooled analysis of sleep duration (6 studies, 16 cohort samples; 30 033 participants; follow-up 2.6-10 years), short sleep was associated with a risk of 1.01 (95% CI 0.93 to 1.10) of developing dyslipidaemia, with moderate heterogeneity (I2=56%, P=0.003) and publication bias (P=0.035). Long sleep was associated with a risk of 0.98 (95% CI 0.87 to 1.10) for dyslipidaemia, with heterogeneity (I2=63%, P<0.001) and no significant publication bias (P=0.248). CONCLUSION The present analysis was unable to find supportive evidence of a significant relationship between sleep duration and the development of dyslipidaemia. However, heterogeneity and small number of studies limit the interpretation. PROSPERO REGISTRATION NUMBER CRD42016045242.
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Affiliation(s)
- Marlot Kruisbrink
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
- Department of Health Services Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
- CAPHRI, Maastricht University, Maastricht, The Netherlands
| | - Wendy Robertson
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Chen Ji
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Michelle A Miller
- Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK
| | - Johanna M Geleijnse
- Division of Human Nutrition, Wageningen University, Wageningen, The Netherlands
| | - Francesco P Cappuccio
- ESH Centre of Excellence in Hypertension & Cardiometabolic Research, University Hospitals Coventry & Warwickshire NHS Trust, Coventry, UK
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Meneton P, Plessz M, Courtin E, Ribet C, Goldberg M, Zins M. L’impact du chômage sur la santé. Med Sci (Paris) 2017; 33:785-789. [DOI: 10.1051/medsci/20173308025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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